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Work Activity Work Order Pa9e 1 <br /> i/21/2011 9:21 <br /> Issued By s�rz SPQONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Irued v3rzott <br /> Fund �ot Account 5 Program 7to Function tte Activity s�3 <br /> Program <br /> Title REPAIR 6 1NCH 4206 TERRACE DR 710119673 <br /> WOfk Ofde�NO Z0����OZ PfOjBCt ACfivity Type CORRECTIVE MAINTENANCE SfBfUS CL <br /> Slatus irs2on Tiine orz� Original WO Billing _ ___ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> Stale Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 • Ext <br /> Second Phone ( 1 • Ext - —— <br /> E-Mail Address <br /> Problem Information <br /> Address 4206 Street TERRACE DR <br /> From Cross Street <br /> To Cross Slreet <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem LEAK LEAK <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiretion Date <br /> Assignment Information <br /> Dept Prioriry Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date _ _ To Be Comp Date _ <br /> Scheduled Date Scheduled Time <br /> Roule Route Sequence <br /> Comments <br /> Action Taken BEAM LOAD BREAK ON 6 INCH C.I.MAIN.PUT ON 12X6 STAINLESS REPAIR CLAMP. <br /> Recommended Action <br /> Approved By BGM2 BEUKERS,GEORGE M. JOb CO51 Ifl(Ofrt18NOf1(Y/N) <br /> StaR Date � � Time Date Completed vtnott Permit No <br /> Compleled By t - — -- __ - Time _ Follow Up7 -- --- <br />